<!DOCTYPE html>
<html lang="en">
<include file="Public:head" />
<body class="page-body" data-url="http://neon.dev">

<div class="page-container"><!-- add class "sidebar-collapsed" to close sidebar by default, "chat-visible" to make chat appear always -->
  
  <include file="Public:sidebar-menu" />

  <div class="main-content">
        
     <include file="Public:top_row" />
    
    <hr />
    
          <ol class="breadcrumb bc-3" >
                <li>
            <a href="index.html"><i class="fa-home"></i>会员系统</a>
          </li>
              <li>
    
                  <a href="forms-main.html">解绑上级</a>
              </li>
            <li class="active">
    
                  <strong>解除绑定申请</strong>
              </li>
              </ol>
          
    <h2>解除绑定申请</h2>
    <br />
    
    <div class="panel panel-primary">
    
      <div class="panel-heading">
        <div class="panel-title">确认解绑信息</div>
    
        <div class="panel-options">
          <a href="#sample-modal" data-toggle="modal" data-target="#sample-modal-dialog-1" class="bg"><i class="entypo-cog"></i></a>
          <a href="#" data-rel="collapse"><i class="entypo-down-open"></i></a>
          <a href="#" data-rel="reload"><i class="entypo-arrows-ccw"></i></a>
          <a href="#" data-rel="close"><i class="entypo-cancel"></i></a>
        </div>
      </div>
    
      <div class="panel-body">
    
        <form role="form" id="form1" method="post" class="validate" action="">
    
          <div class="form-group">
            <label class="control-label">服务人ID</label>
    
            <input type="text" class="form-control" name="up_id" data-validate="required" data-message-required="请输入服务人ID" placeholder="服务人ID"  value="{$up_user.id}" />
          </div>
    
          <div class="form-group">
            <label class="control-label">服务人姓名</label>
    
            <input type="text" class="form-control" name="up_truename" data-validate="required" placeholder="服务人姓名" value="{$up_user.truename}"  />
          </div>
    
          <div class="form-group">
            <label class="control-label">服务人手机号</label>
    
            <input type="text" class="form-control" name="up_mobile" data-validate="required" placeholder="服务人手机号" value="{$up_user.mobile}" />
          </div>
          <div class="form-group">
          <button class="btn btn-success" type="submit" name="submit">解除绑定申请</button>
            <!-- <eq name="jfzr_opne" value="1"><button class="btn btn-success" type="submit" name="submit">解除绑定申请</button><else/>
                <button class="btn btn-primary" type="submit" name="submit" disabled>解除绑定申请未开启</button>
              </eq> -->
            
          </div>
    
        </form>
    
      </div>
    
    </div>
    <!-- Footer -->
    <include file="Public:footer" />
  </div>



  
</div>




  <!-- Bottom scripts (common) -->
  <script src="__PUBLIC__/assets/js/gsap/main-gsap.js"></script>
  <script src="__PUBLIC__/assets/js/jquery-ui/js/jquery-ui-1.10.3.minimal.min.js"></script>
  <script src="__PUBLIC__/assets/js/bootstrap.js"></script>
  <script src="__PUBLIC__/assets/js/joinable.js"></script>
  <script src="__PUBLIC__/assets/js/resizeable.js"></script>
  <script src="__PUBLIC__/assets/js/neon-api.js"></script>


  <!-- Imported scripts on this page -->
  <script src="__PUBLIC__/assets/js/jquery.validate.min.js"></script>
  <script src="__PUBLIC__/assets/js/neon-chat.js"></script>


  <!-- JavaScripts initializations and stuff -->
  <script src="__PUBLIC__/assets/js/neon-custom.js"></script>


  <!-- Demo Settings -->
  <script src="__PUBLIC__/assets/js/neon-demo.js"></script>

</body>
</html>